Publication:

Analysis of neonatal deaths in Maharashtra: policy implications

Background As per statistics on infant mortality, the State of Maharashtra has done well in bringing down IMR from 33 to 21 per 1000 live births. However a lot needs to be achieved still. Various child health programs like home based new born care and others have improved child survival. But the analysis of cases will throw light on actionable points for policy change.

Methods Keeping in mind mortality statistics of the State, an analysis was done on causes of neonatal deaths and social determinants. A retrospective study was done on causes of death from birth to 28 days during 2015-2016 in the State of Maharashtra. 6 deaths per block were reviewed by a committee that included a pediatrician. Verbal autopsy was done and all factors like social, cultural, behavioral as well as factors that resulted in delay in deciding to take the baby to health facility, delay in transport and delay at health facility were studied in details.

Results Latur circle had the highest deaths i.e. 70%, Nashik and Gadchiroli had 62 and 63% respectively. Males were more than females (55.7%). ^0.6% of deaths occurred in babies weighing less than 2500 gms. Delay in deciding to take the baby to the health facility and getting treatment was important (41.4% cases). In 40.8% cases delay in receiving treatment at health facility was observed. Major causes were infections, prematurity and asphyxia.

Conclusions Various causes of neonatal deaths are studied. Delay in deciding to take the baby to the health facility was one of the major factors. Majority of deaths were due to infection prematurity and asphyxia.